Prescription medications covered under Medicare’s drug program vary widely, but physicians should be able to find at least one option among the most popular classes of drugs, according to an analysis of California plans released this week.

Overall, 45 percent of drugs were widely covered among 72 plans in California, and nearly all widely covered drugs, 94 percent, were generic, according to a study published in the Journal of the American Medical Association.

“The coverage of individual drugs varied extensively, indicating the potential difficulties that clinicians can face in knowing which drugs are covered or are more affordable,” wrote Dr. Chien-Wen Tseng of the John A. Burns School of Medicine at the University of Hawaii, who led the study.

The Medicare Part D drug benefit launched in January 2006 was intended to provide relief from soaring drug costs to the nation’s 44 million eligible Medicare beneficiaries, mostly older than 65.

Nearly 23 million people nationwide have signed up to participate in Part D, in which the federal government contracts with private insurers to provide the drug coverage.

Because of all the different plan options and insurers, prescribing drugs to seniors has gotten more complicated for physicians, the authors noted.

Two-thirds of physicians in a previous survey said they lack familiarity with Part D drug lists, called formularies.

And three-fourths of clinicians have been asked by patients or pharmacists to change a prescription because it is not covered under the patient’s plan.

Of the 72 drug plans offered in California examined in this study, they included stand-alone drug plans and Medicare Advantage, or HMO plans with a drug benefit.

Based on the National Ambulatory Medical Care Survey, the researchers looked at coverage for the top seven classes of drugs used by seniors, including heart medications, antidepressants, acid/peptic ulcer drugs, blood glucose regulators, bone-loss drugs, anti-inflammatories and diuretics.

Widely covered drugs were defined as being affordable and available, with a co-payment of $35 or less per prescription.

Formulary coverage was highest for the diuretics and beta blockers, at 90 percent and 85 percent, respectively. Among ACE inhibitors, four of 10 drugs were covered by at least 96 percent of the plans.

However, as few as 7 percent of formularies covered certain angiotensin receptor blockers (ARBs) to control high blood pressure, according to the study.

The research was conducted in the spring of 2006 using data supplied by Medicare. A follow-up review in December indicated that drugs that had since gone generic, such as Zocor and Zoloft, became more widely covered by the plans.

Nearly all the most covered drugs were generic, according to the study.

Still, physicians should not simply prescribe generics and assume they will be covered under most Part D plans, the authors noted. One-forth of the 44 generic drugs studied were not widely covered.

“While encouraging use of generic drugs provides a partial answer, identifying widely covered drugs would be a better policy response to formulary variation,” the authors wrote.

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